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Anxiety & Panic

Anxiety and panic: where is the difference and how can they be managed?

Valbona Uka
Valbona Uka CBT Psychotherapist
| | 5 min read

Anxiety and panic are often experienced similarly at first, but they have clear differences. Anxiety usually appears as a persistent tension and internal worry, while panic arises suddenly and with high intensity, bringing feelings of fear and physical symptoms that seem alarming.

In therapeutic work, however, understanding the differences between them is essential, because it helps us choose the best approach for treatment. To be more specific:

Anxiety usually manifests as a continuous state of worry, tension, and mental overload. The person often lives with repetitive thoughts about the future, responsibilities, negative scenarios, or the feeling that they must have control over everything. In many cases, clients describe this as an internal fatigue that accompanies them throughout the day.

Panic arises suddenly, with high intensity and strong physical symptoms. I have had clients who, during a panic episode, thought they were experiencing something serious with their heart, because the heartbeat becomes very rapid, breathing tightens, and the body goes into alarm.

This distinction is essential in clinical practice, because each therapeutic approach is tailored to the nature of the emotional and physiological response the person is experiencing.

How is anxiety addressed in therapy?

One of the most important elements in my work with clients is first creating an understanding of what is happening. When the person understands that the physical symptoms are a response of the nervous system and not a sign of real danger, the level of fear gradually begins to decrease.

When a client experiences anxiety, the therapeutic work focuses heavily on the thoughts that feed this state. In sessions we often analyze together:

  • which thoughts recur most frequently
  • what activates the emotional tension
  • how the body reacts throughout the day
  • which behaviors keep the anxiety active

In practice I use cognitive techniques to help the client identify automatic thoughts and see them more realistically. In parallel, we work with breathing exercises, body relaxation, and returning attention to the present moment.

Clients often learn that not every thought requires a reaction and not every worry needs to be followed all the way through.

How is panic addressed in therapy?

When dealing with panic episodes, the initial focus is for the client not to be frightened by the physical symptoms themselves, but first to learn how to stabilize when the body goes into alarm.

In therapy we explain that:

  • the racing heartbeat is the body’s response to the alarm
  • shortness of breath does not mean an actual lack of air
  • dizziness is part of high physiological tension

In practice, the first step is restoring the sense of safety in the body. The client is guided to pause for a few seconds and focus on contact with the surrounding reality:

  • to plant their feet firmly on the ground and feel the support
  • to notice the contact of their body with the chair or surface where they are
  • to bring attention to their breathing in a slow and controlled way

Then we work toward having the person not immediately flee the situation, but gradually remain with the sensation until the body calms down.

A very important part is for the client to regain confidence that the episode passes and that they can handle it without losing control.

What helps clients most often?

From clinical experience, many clients benefit when they learn simple techniques they can use immediately:

  • the 4–4–6 breathing technique
  • focusing on the contact of the feet with the ground
  • observing a thought without fighting it
  • reminding oneself: “This feeling will pass.”

A message to readers

Anxiety and panic are not weaknesses. They are the ways the body and mind react when emotional load becomes too great. Often, the most important step is not to remain alone with this experience.

Through Mendje, we aim to create a space where everyone can speak openly, understand themselves better, and receive professional support at the right time. You can book a session with a licensed psychologist directly through the Mendje app.

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